Physiotherapy strategies for functional improvement in a child with complicated hereditary spastic paraplegia: 1-year follow-up of a case report using a changing criterion design.

BACKGROUND: and Purpose: Hereditary spastic paraplegias (HSP) are a group of clinically diverse genetic disorders that share the neurologic symptom of difficulty in walking due to progressive serious muscle weakness and spasticity in the legs. This study describes a physiotherapy program for improving the functional ability of a child diagnosed with complicated HSP and reports the treatment results. METHODS: A 10-year-old boy with complicated HSP received a physiotherapy intervention that included strengthening of the leg muscles and treadmill training for 1 h per session, three to four times a week for 6 weeks. Outcome measures included sit-to-stand, 10-m walk, 1-min walk tests, and gross motor function measures (dimensions D and E). RESULTS: After the intervention, the sit-to-stand, 1-min walk, and 10-m walk test scores improved by 6.75 times, 2.57 m, and 0.05 m/s, respectively. Furthermore, the gross motor function measure dimensions D and E scores improved by 8% (46%-54%) and 5% (22%-27%), respectively. The gains in each parameter were maintained at the 3- and 6-month and 1-year follow-ups. CONCLUSION: These results suggest that structured physiotherapy programs can benefit the functional rehabilitation of children with complicated HSP.

Effects of incorporating dual task into repeated 6-min walk test on balance and walking functions in patients with subacute stroke: A randomized controlled trial.

OBJECTIVE: To explore the effects of incorporating dual task into a repeated 6-min walk test (6MWT) on balance and walking functions in patients with subacute stroke. METHODS: Twenty-eight subacute stroke survivors were randomized into experimental group (EG) and control group (CG). EG and CG participated in dual task during the repeated 6MWT and the repeated 6-min test, respectively, for twice a day, three times weekly over 4 weeks. Outcome assessments were measured pre- and post-test using the 10-m walk test (10MWT), timed up and go test (TUG), 6MWT, Berg balance scale (BBS), and the activities specific balance confidence scale (ABC). RESULTS: In the between-group comparison, change values in the 6MWT and ABC values between pre- and post-test appeared to be significantly different (p < 0.05). In within-group comparisons, the 10MWT, 6MWT, TUG, and ABC scores showed significant differences between pre- and post-test values in two groups (p < 0.05). CONCLUSION: Repeated 6MWT may be beneficial to enhance balance and walking functions in patients with subacute stroke, with more favorable effects when performing dual tasks.

Investigation of walking tasks experienced by community-living individuals with chronic stroke using a validated community ambulation survey.

PURPOSE: This study aimed to demonstrate the necessary walking skills for community ambulation of individuals with chronic stroke using a validated community ambulation survey. METHODS: A total of 107 older adults and 99 ambulatory, urban-living people with chronic stroke were sampled by convenience method. A community ambulation survey was developed to establish content and concurrent validity. Using the survey, older adults and individuals with stroke documented the frequency with which walking tasks were performed throughout the day. RESULTS: The survey was valid for clinical use (kappa coefficients ranging from 0.737 to 0.873). Compared with those encountered by the older adult group, walking tasks less frequently performed by the stroke group included the use of revolving doors, navigating stairs, walking through crossways, carrying and manipulating objects, and walking at a fast pace and for long distances. Participants in the stroke group used automatic doors to enter buildings and walked through underpasses to pass crossways more frequently than those in the older adult group. CONCLUSIONS: These findings identify the walking tasks that people with chronic stroke show less participation in community, which should be involved in routine rehabilitation schedules to restore functional walking in the community.Implications for rehabilitationCommunity ambulation survey is appropriate to identify the challenging walking tasks that people with chronic stroke show less participation in community.People with chronic stroke showed less frequent participation in walking tasks such as using stairs, using crossways, carrying objects, and walking fast and long distances, which are challenging for them.To achieve the final goal of stroke rehabilitation, it is necessary to repeatedly practice challenging walking tasks in a routine rehabilitation schedule.

Is it appropriate to use external loads during side-lying hip abduction exercise for weakened gluteus medius?

BACKGROUND: Side-lying hip abduction exercise could be beneficial to improve the neuromuscular control of the hip abductor; however, there has been limited information available to determine the exercise load during the exercise. OBJECTIVE: This study aimed to demonstrate the effects of using external loads on the hip abductor muscles during side-lying hip abduction exercises in females with gluteus medius (GM) weakness. METHODS: This study enrolled 24 females with weakness in the GM. Electromyographic (EMG) data of the quadratus lumborum (QL) and GM muscles were recorded during the exercise under three load conditions: no-load, external load-1 (3% of body weight), and external load-2 (5% of body weight). RESULTS: During the exercise, the EMG activities of the QL were significantly different under all three conditions (p< 0.05), with greater activity observed in the external load-2 condition (92.05 ± 65.93% maximal voluntary isometric contraction [MVIC]) as compared to the others, and in the external load-1 condition (82.47 ± 57.36% MVIC) as compared to the no-load condition (48.94 ± 45.09% MVIC). Furthermore, the GM/QL ratios showed significant differences between no-load (1.78 ± 1.47) and external load-1 conditions (0.93 ± 0.60), and between no-load and external load-2 (0.85 ± 0.45) conditions (p< 0.05). CONCLUSION: These findings suggest that greater load could be a factor to increase the QL activity during the exercise in females with weakened GM.

One-year follow-up of problem-based task training for a child presenting cerebellar ataxia after brainstem glioma surgery: A single-subject experimental study.

BACKGROUND AND PURPOSE: For the rehabilitation of patients with cerebellar ataxia, task training aids in achieving functional benefits. This study aimed to investigate the effects of problem-based task training on balance and motor function in a child with cerebellar ataxia after brainstem glioma surgery. METHODS: This study used a single-subject reversal design (A-B) with a 1-year follow-up. A 5-year old child with cerebellar ataxia due to a brain glioma completed problem-based task training, including a 10-step walk and return trial, walking while carrying an object, walking between parallel lines, and kicking a ball. Assessments were made using the Pediatric Balance Scale (PBS) and motor function tests (International Cooperative Ataxia Rating Scale (ICARS), Gross Motor Function Measure (GMFM), and Pediatric Evaluation of Disability Inventory (PEDI). RESULTS: During the intervention phase, the PBS score showed clinically and statistically significant improvement compared to the baseline score. The ICARS and GMFM scores improved by 10.53% and 3.56%, respectively, after the intervention. Furthermore, in the PEDI score, functional skills and caregiver assistance in the mobility domain increased by 7.58% and 5.02%, respectively, after the intervention. The improvements in all parameters were maintained or increased at further follow-up phases. CONCLUSION: These findings suggest that problem-based task training has a positive effect on balance and motor function in a child with cerebellar ataxia after brainstem glioma surgery.

Effects of patient-specific mobility therapy for TMJ, neck, and shoulder dysfunction after submandibular gland tumor surgery: a case report.

Aims: This case report describes a patient-specific mobility therapy (PSMT) program to restore range of motion (ROM) and overcome functional limitations of the temporomandibular joint (TMJ), neck, and shoulder in a 48-year-old man who underwent submandibular gland tumor surgery.Methods: The patient also received transcutaneous electrical stimulation and ultrasound to relieve pain. Treatment was provided four sessions per week for four weeks. The measured outcomes included the Neck Disability Index (NDI), Patient-Specific Functional Scale (PSFS), and mobility of the TMJ, neck, and shoulder.Outcomes: The ROM of the TMJ, neck, and shoulder improved from 4.00 mm to 21.00 mm, 1.67 cm to 6.40 cm, and 9.75° to 56.00°, respectively, during the 1st intervention phase when compared with the baseline phase, and these gains were also maintained in the later phases. Furthermore, the NDI and PSFS scores improved by 12.75 points (24.50 to 11.75) and 5.25 points (2.00 to 7.25), respectively.Conclusion: These findings demonstrate the success of PSMT in conjunction with transcutaneous electrical stimulation and ultrasound in alleviating pain and improving targeted impairments for this patient following submandibular gland tumor surgery.

An 18-month follow-up study on the effect of a neuromuscular stabilization technique on Cobb's angle in adolescent idiopathic scoliosis: A single-blind, age-matched controlled trial.

BACKGROUND: The benefits of spinal realignment and stabilization in scoliosis need to be examined. OBJECTIVE: We aimed to investigate the long-term effect of a neuromuscular stabilization technique (NST) on Cobb's angle in patients with adolescent idiopathic scoliosis. METHODS: Twenty females recruited from two hospitals participated in this study. On the basis of convenience of location, participants were allocated to either the experimental group (EG) that underwent the NST, or the control group (CG) that received education for a home exercise program. The NST for the EG was performed for an average of 30 min per session, three times a week for six months, and consisted of spinal realignment and stabilization. Then, 12- and 18-month measurements for long-term follow-ups were conducted for the EG. The outcome measure was Cobb's angle. RESULTS: Between-group comparison revealed a statistically significant difference at post-test (t=-3.26, p< 0.01) but not pre-test (t=-1.36, p= 0.19). Participants of the EG (-6.20 ± 2.49∘) showed greater differences between pre- and post-test scores compared to participants of the CG (-1.40 ± 0.52∘) (p< 0.05). Within-group comparisons showed a significant difference in both groups (p< 0.05). In the EG, Cobb's angle significantly changed across the follow-up sessions (p< 0.05), indicating more improvements by the 12-month (8.50 ± 4.03∘) and 18-month (6.60 ± 3.89∘) follow-ups. CONCLUSION: This study shows that the NST may be a beneficial option to correct spinal alignments in patients with adolescent idiopathic scoliosis.

Use of real-time visual feedback during overground walking training on gait symmetry and velocity in patients with post-stroke hemiparesis: randomized controlled, single-blind study.

This study aimed to determine the efficacy of using real-time visual feedback during overground walking training to improve walking function in patients with post-stroke hemiparesis. Twenty-four patients with post-stroke hemiparesis who were able to walk independently under less impact of synergy pattern on the affected lower limbs (Brunnstrom stage IV or V) were randomly assigned to either the experimental group or the control group. All subjects performed overground walking for 30 min, three times a week for 6 weeks, with real-time visual feedback (weight load to the affected lower limb) provided during training for subjects in the experimental group. Outcome measures comprised the timed up-and-go test and gait parameters (step length, stride length, single and double support times, step and stride length ratios, and single support time ratio). In between-group comparison, the changes between pre-test and post-test scores in all parameters were significantly greater in the experimental group than in the control group (P < 0.05), except for double support time and step length ratio. Furthermore, post-test values of all parameters were significantly more improved in the experimental group than in the control group (P < 0.05). Our findings suggest that real-time visual feedback may be an advantageous therapeutic adjunct to reinforce the effects of overground walking training in patients with post-stroke hemiparesis.

Effects of integrating Neurac vibration into a side-lying bridge exercise on a sling in patients with chronic low back pain: a randomized controlled study.

PURPOSE: This study examined the effects of integrated Neurac vibration during side-lying bridge exercise using a sling system on pain, strength, and balance in patients with chronic low back pain (LBP). Subjects and Methods: A total of 30 patients were randomly assigned to experimental (EG; n = 15) or control groups (CG; n = 15). Both groups performed side-lying bridge exercise; however, the EG group also received Neurac vibration during exercise. Outcome measures included perceived pain level, asymmetry of weight distribution, asymmetry of hip abductor strength (AHAS), and static balance in one-leg standing. A 2 × 2 repeated-measures analysis of variance was used to determine main effects and interaction for each parameter. Results: Significant interaction effects were found between group and time factors for all parameters. Between-group comparisons revealed significant differences in observed changes for all parameters (P < 0.05). In within-group comparisons, EG showed significant changes in all parameters after intervention (P < 0.05); however, significant changes were only found for pain and AHAS in the CG (P < 0.05). Pain score showed greatest effect size (d = 0.77) among all parameters, indicating a moderate effect of intervention. Conclusion: The side-lying bridge exercise on a sling system may alleviate pain and improve strength and balance in patients with chronic LBP, with more favorable effects when Neurac vibration is integrated into the exercise plan.

Initial Evidence on the Impact of Performance-Based Treadmill Training on Pulmonary Function and Physical Performance in a Child with Bronchopulmonary Dysplasia: Single-Subject Experimental Study.

Aim: This study aimed to demonstrate the initial evidence on the impact of performance-based treadmill training on pulmonary function and physical performance of a patient with bronchopulmonary dysplasia (BPD).Methods: This study used a single-subject pre-experimental (A-B) research design (5 and 10 data points during the baseline and intervention phases, respectively) with a 4-month follow-up measurement. The subjects were a 5-year-old child diagnosed with bronchopulmonary dysplasia. Outcome measures were pulmonary function (forced vital capacity [FVC] and peak expiratory flow [PEF]) and physical performance (6-min walk test [6MWT], sit-to-stand test [STS], pediatric balance scale [PBS], and goal attainment scaling).Results: Applying the 2 standard deviation method, the FVC, PEF, 6MWT, and STS test scores showed significant improvement compared to baseline values. In addition, the PBS and goal attainment scaling scores improved by 5.36% (42 points to 45 points) and 29.61% (37.6 points to 59.75 points) after the intervention, respectively. Gains were maintained at the 4-month follow-up.Conclusions: These findings suggest that performance-based treadmill training may be a possible treatment option to improve the pulmonary function and physical performance of children with BPD. Further rigorous studies are needed to establish evidence regarding the effectiveness of the training program among this population.

Four-week training involving self-ankle mobilization with movement versus calf muscle stretching in patients with chronic stroke: a randomized controlled study.

Background: In self-ankle mobilization with movement (S-MWM) therapy, a strap can be utilized to stabilize the posterior glide of the talus during ankle dorsiflexion movements.Objectives: Our objective was to compare the effects of 4-week self-mobilization with movement (S-MWM) with those of calf muscle stretching (CMS) on ankle dorsiflexion passive range of motion (DF-PROM), gait parameters, and fall risk in patients with chronic stroke with limited ankle dorsiflexion.Methods: Participants were randomized into the S-MWM (n = 19) and CMS groups (n = 19). Both groups received conventional physiotherapy for 30 minutes per session. In addition, S-MWM and CMS techniques were performed 3 times per week for 4 weeks and were performed by the participants themselves. Ankle DF-PROM, gait parameters, and fall risk were measured after 4 weeks of training.Results: After 4 weeks of training, both groups showed significant improvement in all outcome measures (p < .05). Furthermore, ankle DF-PROM, gait parameters (gait speed, cadence, and stride lengths on both sides), and fall risk showed greater improvement in the S-MWM group than in the CMS group (p < .05).Conclusions: This study shows that S-MWM training combined with conventional physiotherapy improved ankle DF-PROM, gait parameters, and fall risk in patients with chronic stroke.

Repeated Use of 6-min Walk Test with Immediate Knowledge of Results for Walking Capacity in Chronic Stroke: Clinical Trial of Fast versus Slow Walkers.

AIM: This study aimed to determine the effects of repeated use of the 6-minute walk test (6MWT) with immediate knowledge of results (KR) on the walking capacity by comparing fast and slow walkers in patients with chronic hemiparesis. METHODS: Twenty-five subjects were allocated to 2 groups depending on their walking speed1: Group 1 (fast walkers, n1 = 11): greater than equal to .8 m/s and2 Group 2 (slow walkers, n2 = 14): less than .8 m/s. All subjects underwent the 6MWT once a day, 5 days a week, for 4 weeks (a total of 20 sessions). The 6MWT was performed on a 30-m path with immediate KR; subjects informed the time taken to walk each 30-m path. Outcome measures included the 6MWT and 10-meter walk test (10MWT). Measurements were taken before and after 4 weeks. Results of within-group comparisons showed significant improvements in the 10MWT and 6MWT for both groups pre- and post-test (P < .05). Furthermore, in between-group comparison, results of Group 1 differences were greater between pre- and post-test in the 10MWT and 6MWT values as compared to Group 2 (P < .05). These findings indicate that repeated use of the 6MWT with immediate KR may be beneficial to enhance walking capacity in patients with chronic stroke, with more favorable changes in better poststroke walking speed.

An 8-week scapular stabilization exercise program in an elite archer with scapular dyskinesis presenting joint noise: A case report with one-year follow-up.

This case report demonstrates the effects of a scapular stabilization exercise program for managing the clinical symptoms of scapular dyskinesis in an archer presenting joint noise during shoulder movement. A 31-year-old man with a 20-year career in archery who complained of scapular dyskinesis and joint noise during shoulder movement was referred for proper management. The player performed the scapular stabilization exercise program, with an emphasis on strengthening scapular stabilizers and neutralization of scapular position, for 40 min, three times per week for 8 weeks (a total of 24 sessions). Measurements included the extent of scapular deviation, strength of scapular stabilizers, emotional burden related to joint noise, and upper limb disability. These measurements were taken before and after the intervention and during 1-year follow-up. After the 8-week intervention, scapular position improved by a range of 3.75-12.88% and muscle strength improved by a range of 8.69-28.60%. Further, emotional burden and upper limb disability improved by 56.86% and 91.67%, respectively. A 1-year follow-up showed that these improvements had been favorably maintained. These findings indicate that shoulder stabilization exercise may be helpful for alleviating scapular and shoulder problems related to archery performance.

Effects of Corrective Exercise for Thoracic Hyperkyphosis on Posture, Balance, and Well-Being in Older Women: A Double-Blind, Group-Matched Design.

BACKGROUND AND PURPOSE: The purpose of this study was to identify the effects of a corrective exercise for thoracic hyperkyphosis on posture, balance, and well-being in Korean community-dwelling older women. METHODS: Fifty women 65 years of age and older, recruited from 2 senior centers, participated in this study. Participants were assigned to either the experimental group (EG) or the control group (CG) on the basis of convenience of location, and 22 in each were analyzed. Participants in the EG underwent a thoracic corrective exercise program 1 hour each session, twice per week for 8 weeks (a total of 16 sessions), which consisted of specific exercises to enhance breathing, thoracic mobility and stability, and awareness of thoracic alignment. The CG received education on the same thoracic corrective exercise program and a booklet of the exercises. Outcome measures included the extent of postural abnormality (angle of thoracic kyphosis, kyphosis index calculated both in relaxed- and best posture using flexicurve, the ratio of the kyphosis index calculated best posture/relaxed posture, craniovertebral angle, and tragus-to-wall distance), balance (Short Physical Performance Battery and limit of stability), and well-being (Geriatric Depression Scale Short Form and the 36-Item Short Form Health Survey [SF-36]). All data were collected by 6 blinded assessors at baseline, at 8 weeks after the completion of intervention, and at 16 weeks for follow-up. RESULTS AND DISCUSSION: For participants of the EG, means of all parameters showed significant improvements over time (P < .05), with improved values both in comparison of baseline to postintervention and baseline to follow-up. Means of CG parameters were significantly improved in only the angle of thoracic kyphosis and the tragus-to-wall distance (P < .05). Furthermore, in all parameters, percent change between baseline and postintervention data was significantly (P < .05) higher for the EG than that for the CG, except for the limit of stability and SF-36 which improved but not significantly. All parameters between baseline and follow-up data were significantly (P < .05) higher for the EG than those for the CG, except for the limit of stability. CONCLUSIONS: The findings of this study suggest that a well-designed exercise program may be beneficial to improve spinal posture, balance, and well-being in older women with thoracic hyperkyphosis. We recommend the use of the therapeutic strategies utilized in this study to enhance thoracic posture, balance, and well-being of older women with thoracic hyperkyphosis. Future research is needed to apply this exercise protocol on a larger and more diverse population.

Rhythmic arm swing integrated into treadmill training in patients with chronic stroke: A single-subject experimental study.

Normal walking includes coordinated and controlled movement of the legs and arms. However, patients following stroke often present with inappropriate motor control which limits coordinated movement patterns of the affected limbs. This study aimed to compare the effects of rhythmic arm swing and arm fixation during treadmill walking in patients with poststroke hemiparesis. We used an alternating study design with multiple baselines across subjects. Three patients with chronic stroke participated in this study. During treadmill walking, rhythmic arm swing and arm fixation conditions were alternately applied. Outcome measures included the 10-meter walk test (10MWT) and energy expenditure index (EEI). In the intervention phase, all subjects showed significantly greater improvements in the 10MWT and EEI scores for rhythmic arm swing condition compared to those for arm fixation condition (p < 0.05). 10MWT improvement rates: Subject 1-34.81% vs. 15.75%; Subject 2-40.00% vs. 17.95%; and Subject 3-38.08% vs. 21.85%; and EEI improvements: Subject 1-23.19% vs. 14.08%; Subject 2-26.15% vs. 20.43%; and Subject 3-22.99% vs. 14.49%. These findings suggest that rhythmic arm swing is clinically feasible as a more favorable option to enhance the effects of treadmill walking training. However, larger studies with a different study design are needed to be able to make any judgment about the usefulness of the treatment.

Effects of integrating rhythmic arm swing into robot-assisted walking in patients with subacute stroke: a randomized controlled pilot study.

This study aimed to identify the effects of rhythmic arm swing during robot-assisted walking training on balance, gait, motor function, and activities of daily living among patients with subacute stroke. Twenty patients with subacute stroke were recruited, and thereafter randomly allocated to either the experimental group that performed the robot-assisted walking training with rhythmic arm swing, or the control group that performed the training in arm fixation. In total, 30 training sessions were carried out. The outcome measures included the 10-m walk test, Berg balance scale, timed up-and-go test, fall index that was measured using the Tetrax system, motor function test of Fugl-Meyer assessment, and modified Barthel index. The patients of both groups showed significant improvement in all parameters after the intervention (P<0.05). The Berg balance scale, Fugl-Meyer assessment, and modified Barthel index scores at post-test appeared to be significantly higher for the experimental group than for the control group (P<0.05). These findings indicate that more favorable effects from robot-assisted walking training in patients with subacute stroke may be obtained by the use of rhythmic arm swing.

Action observation training of community ambulation for improving walking ability of patients with post-stroke hemiparesis: a randomized controlled pilot trial.

PURPOSE: To investigate the effects of action observation training involving community-based ambulation for improving walking ability after stroke. DESIGN: Randomized, controlled pilot study. SETTING: Inpatient rehabilitation hospital. SUBJECTS: A total of 25 inpatients with post-stroke hemiparesis were randomly assigned to either the experimental group ( n = 12) or control group ( n = 13). INTERVENTION: Subjects of the experimental group watched video clips demonstrating four-staged ambulation training with a more complex environment factor for 30 minutes, three times a week for four weeks. Meanwhile, subjects of the control group watched video clips, which showed different landscape pictures. MAIN MEASURES: Walking function was evaluated before and after the four-week intervention using a 10-m walk test, community walk test, activities-specific balance confidence scale, and spatiotemporal gait measures. RESULTS: Changes in the values for the 10-m walk test (0.17 ±0.19 m/s vs. 0.05 ±0.08 m/s), community walk test (-151.42 ±123.82 seconds vs. 67.08 ±176.77 seconds), and activities-specific balance confidence (6.25 ±5.61 scores vs. 0.72 ±2.24 scores) and the spatiotemporal parameters (i.e. stride length (19.00 ±11.34 cm vs. 3.16 ±11.20 cm), single support (5.87 ±5.13% vs. 0.25 ±5.95%), and velocity (15.66 ±12.34 cm/s vs. 2.96 ±10.54 cm/s)) indicated a significant improvement in the experimental group compared with the control group. In the experimental group, walking function and ambulation confidence was significantly different between the pre- and post-intervention, whereas the control group showed a significant difference only in the 10-m walk test. CONCLUSIONS: Action observation training of community ambulation may be favorably used for improving walking function of patients with post-stroke hemiparesis.

Effects of action observation therapy on hand dexterity and EEG-based cortical activation patterns in patients with post-stroke hemiparesis.

BACKGROUND: Previous reports have suggested that action observation training (AOT) is beneficial in enhancing the early learning of new motor tasks; however, EEG-based investigation has received little attention for AOT. OBJECTIVE: The purpose of this study was to illustrate the effects of AOT on hand dexterity and cortical activation in patients with post-stroke hemiparesis. METHOD: Twenty patients with post-stroke hemiparesis were randomly divided into either the experimental group (EG) or control group (CG), with 10 patients in each group. Prior to the execution of motor tasks (carrying wooden blocks from one box to another), subjects in the EG and CG observed a video clip displaying the execution of the same motor task and pictures showing landscapes, respectively. Outcome measures included the box and block test (BBT) to evaluate hand dexterity and EEG-based brain mapping to detect changes in cortical activation. RESULTS: The BBT scores (EG: 20.50 ± 6.62 at pre-test and 24.40 ± 5.42 at post-test; CG: 20.20 ± 6.12 at pre-test and 20.60 ± 7.17 at post-test) revealed significant main effects for the time and group and significant time-by-group interactions (p < 0.05). For the subjects in the EG, topographical representations obtained with the EEG-based brain mapping system were different in each session of the AOT and remarkable changes occurred from the 2nd session of AOT. Furthermore, the middle frontal gyrus was less active at post-test than at pre-test. CONCLUSIONS: These findings support that AOT may be beneficial in altering cortical activation patterns and hand dexterity.

Effects of mirror therapy integrated with task-oriented exercise on the balance function of patients with poststroke hemiparesis: a randomized-controlled pilot trial.

This study aimed to explore the effects of mirror therapy integrated with task-oriented exercise on balance function in poststroke hemiparesis. Twenty patients with poststroke hemiparesis were assigned randomly to an experimental group (EG) and a control group (CG), with 10 individuals each. Participants of the EG and CG received a task-oriented exercise program with a focus on the strengthening of the lower limb and the practice of balance-related functional tasks. An additional option for the EG was front and side wall mirrors to provide visual feedback for their own movements while performing the exercise. The program was performed for 30 min, twice a day, five times per week for 4 weeks. Outcome measures included the Berg balance scale, the timed up-and-go test, and quantitative data (balance index and dynamic limits of stability). In the EG and CG, all variables showed significant differences between pretest and post-test (P<0.05), and post-test values of all variables appeared to be significantly different between two groups (P<0.05). Furthermore, in the EG, the change values between pretest and post-test values of Berg balance scale (13.00±3.20 vs. 6.60±4.55 scores), and timed up-and-go test (6.45±3.00 vs. 3.61±1.84 s), balance index (2.29±0.51 vs. 0.96±0.65 scores), dynamic limits of stability (7.70±3.83 vs. 3.70±4.60 scores) were significantly higher than those of the CG (P<0.05). The findings suggest that a mirror therapy may be used as a beneficial therapeutic option to facilitate the effects of a task-oriented exercise on balance function of patients with poststroke hemiparesis.

The Use of Task-based Cognitive Tests for Defining Vocational Aptness of Individuals with Disabilities.

OBJECTIVES: The purpose of this study was to demonstrate the use of task-based cognitive tests to detect potential problems in the assessment of work training for vocational rehabilitation. METHODS: Eleven participants with a normal range of cognitive functioning scores were recruited for this study. Participants were all trainees who participated in a vocational training program. The Rey Complex Figure Test and the Allen Cognitive Level Screen were randomly administered to all participants. Responses to the tests were qualitatively analyzed with matrix and scatter charts. RESULTS: Observational outcomes derived from the tests indicated that response errors, distortions, and behavioral problems occurred in most participants. These factors may impede occupational performance despite normal cognitive function. These findings suggest that the use of task-based tests may be beneficial for detecting potential problems associated with the work performance of people with disabilities. CONCLUSION: Specific analysis using the task-based tests may be necessary to complete the decision-making process for vocational aptness. Furthermore, testing should be led by professionals with a higher specialization in this field.